Hope for the Hopeless

On a chilly, gray morning in the Romanian town of Hirlau, Dr. Barbara Bascom is touring a ward full of orphans. Working her way through the moldering rooms, the air dank and the windows barred, she pauses repeatedly to examine the youngsters or to cuddle and coo. She is greeted mostly by dazed looks from the children, many of whom have severe deformities, but Bascom maintains her air of optimism. Then, suddenly, she stops, peering at a child in one corner. He is lying in his bed on his back, motionless. As a visitor approaches him, he jerks his small hands protectively in front of his face. The woman holds out a toy, a small stuffed penguin, and moves it back and forth. The child's expressionless eyes track the movement, but there is no other reaction. Turning away, Bascom says sadly, "That child has given up."

Mercifully, Bascom herself has not. A year ago, she wryly concedes in her soft Texas twang, "I barely knew where Romania was." Then came the overthrow and execution of Communist dictator Nicolae Ceausescu—and in the wake of the revolution in Bucharest, the world began to learn of the terrible plight of Romania's orphans. More than 130,000 Romanian children under the age of 18 were being warehoused in conditions that were often appalling. Many suffered from severe malnutrition and disease, and some 2,500 were infected with HIV, the result of unscreened blood transfusions. For Bascom, 54, a pediatrician and child-development expert, it was a crisis that could not be ignored. And so last April she left her government job and her comfortable Maryland home. With her husband, Jim, 56, a surgeon, she moved to Romania to help in the international relief effort aimed at repairing the terrible damage.

It will be a staggering task to undo four decades of neglect and misrule. Obsessed with boosting the country's population from 23 million to 30 million by the year 2000 as a way of stimulating economic growth, Ceausescu outlawed birth control and permitted abortions only for women who had already had at least five children or who were over the age of 45. (Such draconian laws have since been revoked.) Miscarriages were investigated by the frighteningly efficient Securitate, the secret police. Meanwhile, the government squandered money on grandiose schemes, including the Bucharest-Danube Canal, which remains unfinished; development stalled, and today Romania is one of the poorest countries in Europe. Saddled with big families and chronic shortages of food, fuel and electricity, desperate parents dumped their unwanted children in state institutions. Many of Romania's orphans" ' are not orphans at all; they are simply unwanted.

The Ceausescu regime viewed the abandoned kids as nothing more than a potential source of labor. At age 3, those deemed "normal" were sent to preschool facilities, then to boarding schools where they learned manual skills. (Many of them, suitably dehumanized by years of institutional life, were eventually recruited into the Securitate.) But for roughly 40,000 children with physical and mental disabilities, and even such easily remedied afflictions as cleft palates or protruding ears, there was no means of escape. These supposed "irrecuperables" landed in wretched facilities that resembled 19th-century asylums—or even World War II concentration camps.

Nothing in her 25 years in the field of child development had prepared Bascom for the conditions she found when she first visited Romania last April. Invited to the country as a consultant by the Romanian Ministry of Health, she found the experience almost overwhelming. "There was room after room chock-full of old metal cribs with wire mesh, like cages," she says, recalling the first orphanages. ""One stood next to the other, all full of children, standing or sitting or lying." Paint peeled from the walls, and there was a sickening smell of urine, which soaked many of the mattresses. The smallest babies were swaddled so tightly to protect against the chill of the rooms that they could hardly move. "All you could see was their little eyes. They lived in their cribs. They had no toys; they never went outside." Basically all they had was each other, a camaraderie that still exists. "They form little families," she says. "A child who is physically handicapped teams up with a stronger child who is retarded. He'll tell you, I am his brains, he is my legs.' "

Not surprisingly, nearly every child exhibited signs of serious psychological trauma. "There was no reaching for you, no calls of 'Mama.' " Bascom remembers. "Most would recoil if you approached them quickly. If you picked them up, they got tense, started shaking, because it was a new experience for them and they weren't processing it very well." Often when Bascom reached down to cuddle a child, she was met by what she terms the "orphan's salute," tiny hands pulled to their faces in apprehension. "The ones that would let you pick them up were wet," she says. "You had to be careful, because it was a relatively distasteful experience. They didn't smell nice; they didn't cuddle." Most eerie of all was the constant rocking by the children as they tried desperately to give themselves some sort of stimulation. "You'd look into a room, and they're all just swaying back and forth in unison, this absolute sea of rocking children," she says. "And it's utterly silent except for this clicking of the metal cribs."

Bascom quickly volunteered to design a full-scale rehabilitation effort. She had no choice, she felt. "At about the second institution I visited, I said, 'That's it,' " she recalls. "I had to be here."

She found the orphanage staff overwhelmed and suffering from grief and frustration. "The doctors, nurses, therapists and psychologists were as much of a tragic story as the children," she says. "During the Ceausescu regime, they had to hide children who needed special care, and to falsify records so the children wouldn't be sent to homes for the irrecuperable. Doctors bought medicine on the black market to treat children in the orphanages." In the wards, the pain of the nurses was all too evident. "They didn't have time to give to the children, all they could do was feed and change them. When they tried to give, the children rejected them."

Since moving to Romania, Bascom has begun an ambitious program that will bring therapy to children and training to professionals and volunteers in eight orphanages. These will serve as models and resource facilities for institutions throughout the country. Bascom's main funding comes from the Christian relief agency World Vision International, which has budgeted $1.25 million annually over the next three years. Bascom's program is aimed specifically at the 40,000 orphans under the age of 7 who stand the best chance of recovery. Targeting the population most urgently in need, she says, "you have to start somewhere—maximum impact with limited resources." At the pilot site in the northern city of Iasí, her zeal and knowledge have had a tonic effect on her Romanian colleagues. "I admire her power. She has big power to fight for good," says Dr. Olimpia Marcovei, a Romanian pediatrician and orphanage inspector. "She fights for these children as if they were her own."

In a way, that is how Bascom sees it, too. Born in San Antonio, Texas, where her father was a vice president of Sinclair Oil, she always wanted to be a doctor. When she was 11, a form of childhood arthritis forced her to stay in bed for a year, during which she "read and read." The story of Albert Schweitzer especially captured her fancy. "First I was fascinated, then totally enamored," she recalls. "I wanted to grow up and go to the Belgian Congo and work for him. He was sort of my guru." Her determination never wavered, and she eventually enrolled at the University of Colorado medical school, one of only four women in a class of 96 students.

After her first year in med school, Bas-com married a law student named Bob Greuter. Told erroneously that they could not bear children, they eventually decided to adopt. As it turned out, that experience only underscored for Barbara the need for more enlightened child-care policies. She and her husband had heard about an unwed mother who wanted to give up her baby. But the local adoption agency balked at listing the boy, Eric, because he had a club foot. "They had these weird notions, which included restrictions on handicapped children;" says Barbara. "But I went to see Eric, and it was instant attachment." The couple prevailed on adoption officials to let them have Eric, now 26, whose foot was ultimately repaired by surgery and who is now a photographer in Aspen, Colo. Four years later, their son, Fritz, was born.

Things didn't turn out so well for the Greuters' marriage. Barbara, who had set up a pediatric practice in Aspen, concedes that she was frequently traveling. In addition to caring for her patients, she had become active in policy-making for handicapped children and had been appointed. chairwoman of the planning committee for the Colorado Developmental Disabilities Council. In 1973 she and Greuter divorced after 13 years of marriage. About the same time, she became friendly with Dr. Jim Bascom, also divorced and the father of four, who as a young surgeon in the mid-'60s had gone off to work at the Albert Schweitzer Hospital in Haiti.

Bonded by a mutual desire for challenge and a certain restlessness, they married in 1974. Four years later, Jim, who had been an Army surgeon in Vietnam, proposed that they join the Army Medical Corps. The pair, with Barbara commissioned as a major, shipped off to Madigan Army Medical Center in Tacoma, Wash. A devout music lover (especially, she says, "Bach, Bach and Bach"), she went to concerts and indulged her passion for sailing.

But in 1982, stirred once again by wanderlust, they moved to Saudi Arabia and worked as doctors for Aramco, returning four years later to the States, where Barbara worked as a child-development specialist at Walter Reed Army Medical Center in Washington, D.C., and Jim started his own company to put medical information on computer disks for use in Third World countries. Given the frequent uprootings, Barbara says their decision to move to Romania wasn't too difficult. Their only real regret was having to sell their four-bedroom colonial home in Maryland, which they had lovingly restored and furnished.

Their life and circumstances in Romania are considerably more modest. She and Jim, who is running a program to provide medical information to local doctors, have a house in Iasì and a small apartment in Bucharest, 250 miles away. (Son Fritz. 22, who is studying in Iasì, sometimes helps out at the orphanage.) Like many homes in Romania, neither of theirs has a steady supply of hot water. ("I'm going to have to get some soon, or I'm going to start smelling funny," says Barbara.) Her days are filled with meetings with visiting doctors and foreign relief officials, as well as drawn-out discussions with Romanian health authorities. "There is no resistance," says Bascom. "it's just that the ideas we're introducing are novel, and they want to understand."

Money, facilities and programs are all desperately needed, but it is love and attention that are truly essential. "A lot of these children just need to be held," says Bascom. "That has to come first." Under the Ceausescu regime, officials didn't consider health care a productive industry, so they denied doctors and medical personnel access even to some basics of pediatrics. These days in Iasì the staff has tripled, and the numbers of volunteers are growing steadily. Visiting specialist Gale Haradon, an occupational therapist from Denver, runs training sessions for medical students, dispenses advice and demonstrates therapeutic techniques. Simple changes like taking care to position babies on their stomachs rather than their backs can make a big difference. "The baby starts to push with his arms and develops more quickly," says Bascom. Another American, Thelma Roach, is also helping mend psychological scars with a host of novel activities and procedures. One involves simply hanging each child's picture above his or her coat hook, since experience has taught Roach that this can be an effective way of helping institutionalized kids to develop a sense of themselves.

Paradoxically one of Bascom's chief concerns is that the children, deprived for so long, may suffer overstimulation in a new environment. "They need a lot of structure in their lives," she says. For evidence, she points to Vasile, 4, who was seriously malnourished and withdrawn when she met him but who is now a bright-eyed boy in a red-and-blue outfit. "Vasile grabs all the toys and hoards them like a little beaver," she says. "He goes straight for dessert and won't eat his food. He's living on cookies and indulgence." Despite his two club feet, Vasile is one of the lucky ones. A family from Toronto has adopted him, though Bascom cautions that they will need professional guidance in giving him the love he missed earlier in his life. "Children may respond to unaccustomed physical affection by rejection," says Bascom. "These are children with special needs."

Bascom firmly believes that 85 percent of the kids can eventually overcome their developmental problems. Judging from the gains made by some of the children at the Iasì facility, that may not be an unrealistic goal. Last year, little Gabriela, 3, seemed almost beyond hope. She was among the most furious rockers and couldn't talk at all. "She was so withdrawn, we thought she was going to be psychotic or autistic," says Bascom. "She wouldn't touch or accept touching." Now, after intensive work with therapists Roach and Haradon, she is showing remarkable progress. Though she still doesn't speak, she now climbs fearlessly from crib to crib to visit neighboring kids.

Though conditions at the institutions are improving, Bascom cannot predict what will happen. Some of the children will eventually go back to their Romanian homes. Others will be adopted. As word of Romania's orphan crisis has spread, there has been a growing stream of couples from countries including the U.S., Canada and most of Europe to inquire about the availability of children. "It's kind of crazy right now, planeloads of people literally going baby-shopping," says Bascom. Already, more than 200 kids have been adopted by American families. Bascom and her colleagues are concerned about charlatans and opportunists who see a potential source of black-market babies—and have turned away several shady characters. Bascom is also determined that children infected with the AIDS virus not be neglected. "They are perhaps the neediest group," she says. ""Once they're diagnosed, things stop in their lives. They need loving and touching." So far, none of the HIV-infected children have been adopted.

All in all, it is a grueling, at times heartrending ordeal. "It is emotionally draining," says Bascom. "But I've never felt so energized or motivated." When Bascom reflects on the kids she is working with at the Hirlau home for the irrecuperable, she is deeply impressed by the resilience of the survivors. "If you put me there, I'd be dead within six months." she says. "But I like to look at the positive. It's easy to get caught up in how horrible these places are and not how wonderful these children are. Our hearts break for them—but their hearts are not broken."